Darwin R. Labarthe

‘Surveillance’ has many connotations and is considered sometimes to be synonymous with ‘monitoring’ or ‘intelligence’, thought sometimes to be a tool for research and sometimes specifically distinguished from research, and regarded sometimes as an essential tool for program evaluation and sometimes as unsuited to this purpose. The objective of this presentation, which complements detailed examples of surveillance activities and available data sources reviewed by other speakers, is to consider surveillance in its broadest sense in the specific context of cardiovascular health (CVH). A framework is suggested that represents the full ‘natural history’ of development of cardiovascular diseases (CVD), in all their manifestations, in juxtaposition with the several levels of intervention that correspond to the progressive development of CVD. From the perspective of CVH programs, all elements of this framework require surveillance if an adequate accounting of the disease process and opportunities for intervention is to be achieved for any particular population. Many writers about surveillance emphasize the importance of application of the results through effective communication of health messages, whether to the public at large, policy makers, health care providers, or others. A valuable reference for further discussion of this and other aspects of surveillance is the text by Teutsch and Churchill, published in its second edition by Oxford University Press, Oxford, 2000.